Ultrasound-guided laser-induced thermal therapy for small palpable invasive breast carcinomas: a feasibility study - PubMed (original) (raw)

Ultrasound-guided laser-induced thermal therapy for small palpable invasive breast carcinomas: a feasibility study

S van Esser et al. Ann Surg Oncol. 2009 Aug.

Abstract

Background: The next step in breast-conserving surgery for small breast carcinomas could be local ablation. In this study, the feasibility of ultrasound-guided laser-induced thermal therapy (LITT) is evaluated.

Methods: Patients with large-core needle biopsy-proven invasive, palpable breast carcinoma (clinically <or=2 cm) underwent ultrasound-guided LITT, followed by surgical excision. Completeness of ablation was determined by both hematoxylin and eosin staining and nicotinamide adenosine diaphorase staining.

Results: Fourteen patients completed the treatment. The mean histological tumor size was 17 mm (range, 8-37 mm); 6 of 14 tumors were histologically larger than the clinical entry threshold of 2 cm. The power applied in all patients was 7 W, and the mean treatment time was 21.4 min (range, 15-30 min). In one patient, a skin burn occurred, and one patient had a localized pneumothorax that could be treated conservatively. In 7 (50%) of 14 patients, the tumor was completely ablated, as confirmed by nicotinamide adenosine diaphorase staining. In 11 cases, extensive in-situ carcinoma was present. In one case, the in-situ carcinoma was also completely ablated. A total of seven (88%) of eight tumors <2 cm in size were completely ablated versus one (17%) of six tumors that were >or=2 cm in size (P = .026).

Conclusions: Successful LITT of invasive breast cancer seems to be feasible when confined to small (<2 cm) nonlobular carcinomas without surrounding extensive in-situ component and angioinvasion. However, to implement LITT in a curative setting, improvements in imaging to more reliably preoperatively assess tumor size and monitoring of fiber tip placement and treatment affect are essential.

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Figures

Fig. 1

Fig. 1

Macroscopic view of ablated tumor tissue. Outer circle indicates the ablation zone; inner circle shows fiber track

Fig. 2

Fig. 2

Microscopic view of ablation zone (hematoxylin and eosin; original magnification, ×25). Arrow indicates position of laser-induced thermal therapy probe

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References

    1. {'text': '', 'ref_index': 1, 'ids': [{'type': 'PubMed', 'value': '2927449', 'is_inner': True, 'url': 'http://pubmed.ncbi.nlm.nih.gov/2927449/'}\]}
    2. Fisher B, Redmond C, Poisson R, et al. Eight-year results of a randomized clinical trial comparing total mastectomy and lumpectomy with or without irradiation in the treatment of breast cancer. N Engl J Med. 1989;320:822–8. - PubMed
    1. {'text': '', 'ref_index': 1, 'ids': [{'type': 'DOI', 'value': '10.1001/jama.259.23.3413', 'is_inner': False, 'url': 'https://doi.org/10.1001/jama.259.23.3413'}, {'type': 'PubMed', 'value': '3373679', 'is_inner': True, 'url': 'http://pubmed.ncbi.nlm.nih.gov/3373679/'}\]}
    2. Mann BA, Samet JM, Hunt WC, et al. Changing treatment of breast cancer in New Mexico from 1969 through 1985. JAMA. 1988;259:3413–7. - PubMed
    1. {'text': '', 'ref_index': 1, 'ids': [{'type': 'DOI', 'value': '10.1056/NEJMoa020989', 'is_inner': False, 'url': 'https://doi.org/10.1056/nejmoa020989'}, {'type': 'PubMed', 'value': '12393819', 'is_inner': True, 'url': 'http://pubmed.ncbi.nlm.nih.gov/12393819/'}\]}
    2. Veronesi U, Cascinelli N, Mariani L, et al. Twenty-year follow-up of a randomized study comparing breast-conserving surgery with radical mastectomy for early breast cancer. N Engl J Med. 2002;347:1227–32. - PubMed
    1. {'text': '', 'ref_index': 1, 'ids': [{'type': 'DOI', 'value': '10.1016/S1072-7515(98)00011-8', 'is_inner': False, 'url': 'https://doi.org/10.1016/s1072-7515(98)00011-8'}, {'type': 'PubMed', 'value': '9510258', 'is_inner': True, 'url': 'http://pubmed.ncbi.nlm.nih.gov/9510258/'}\]}
    2. Borgstein PJ, Pijpers R, Comans EF, et al. Sentinel lymph node biopsy in breast cancer: guidelines and pitfalls of lymphoscintigraphy and gamma probe detection. J Am Coll Surg. 1998;186:275–83. - PubMed
    1. {'text': '', 'ref_index': 1, 'ids': [{'type': 'DOI', 'value': '10.1038/sj.bjc.6602895', 'is_inner': False, 'url': 'https://doi.org/10.1038/sj.bjc.6602895'}, {'type': 'PMC', 'value': 'PMC2361072', 'is_inner': False, 'url': 'http://www.ncbi.nlm.nih.gov/pmc/articles/pmc2361072/'}, {'type': 'PubMed', 'value': '16333306', 'is_inner': True, 'url': 'http://pubmed.ncbi.nlm.nih.gov/16333306/'}\]}
    2. Anttinen J, Kautiainen H, Kuopio T. Role of mammography screening as a predictor of survival in postmenopausal breast cancer patients. Br J Cancer. 2006;94:147–51. - PMC - PubMed

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